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McCurdy BH, Bradley T, Matlow R, Rettger JP, Espil FM, Weems CF, Carrion VG. Program evaluation of a school-based mental health and wellness curriculum featuring yoga and mindfulness. PLoS One 2024; 19:e0301028. [PMID: 38574083 PMCID: PMC10994323 DOI: 10.1371/journal.pone.0301028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 03/01/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Interest in the effectiveness of mindfulness-based interventions such as yoga in primary schools has grown. Evidence shows promise, as youth who engage in yoga to promote mindfulness show improved coping skills, increased socio-emotional competence and prosocial skills, academic performance, attention span, and ability to deal with stress. OBJECTIVE This study reports the results of a program evaluation of a universal health and wellness curriculum, Pure Power, designed to teach youth yoga techniques, mindfulness, and emotion regulation. METHODS A non-randomized comparison design examined outcomes among participants from schools that completed the intervention with highest fidelity of implementation (n = 461) and from students in matched comparison schools (n = 420). Standard measures of coping, emotion regulation and emotion dysregulation, spelling, and math achievement were collected. RESULTS Analyses suggest the youth in the intervention schools demonstrated relative improvement on measures of emotion regulation, spelling, and math. CONCLUSIONS Challenges in implementation in real-life settings are vital to identify. The data provide some real-world evidence for the effectiveness of a universal health and wellness curriculum on emotion regulation and positive academic outcomes. Training school staff to deliver the intervention may foster implementation. Future research should test the effectiveness of who delivers the intervention; for example, teacher-delivered groups vs. other wellness personnel.
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Affiliation(s)
- Bethany H. McCurdy
- Human Development and Family Studies, Iowa State University, Ames, Iowa, United States of America
| | - Travis Bradley
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Ryan Matlow
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California, United States of America
| | - John P. Rettger
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Flint M. Espil
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Carl F. Weems
- Human Development and Family Studies, Iowa State University, Ames, Iowa, United States of America
| | - Victor G. Carrion
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California, United States of America
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2
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Jagiello T, Belcher J, Neelakandan A, Boyd K, Wuthrich VM. Academic Stress Interventions in High Schools: A Systematic Literature Review. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01667-5. [PMID: 38436893 DOI: 10.1007/s10578-024-01667-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2024] [Indexed: 03/05/2024]
Abstract
The experience of academic stress is common during high school and can have significant negative consequences for students' educational achievement and wellbeing. High school students frequently report heightened levels of school-related distress, particularly as they approach high-stakes assessments. Programs designed to reduce or prevent academic stress are needed, and their delivery in school settings is ideal to improve treatment access. The current review aimed to examine the effectiveness of high school-based programs in reducing or preventing academic stress. A systematic search returned 31 eligible studies across 13 countries. Programs were categorised according to intervention type, format, and facilitator. Results showed that the methodological quality of most studies was poor, and many used an inactive control group. As predicted by theories of academic stress, the strongest evidence was for programs grounded in cognitive-behavioural therapy (CBT). There was evidence that both universal and targeted approaches can be beneficial. The unique implementation issues for these two formats are discussed. Most programs were delivered by psychologists and were generally effective, but almost all of these were CBT programs. A smaller proportion of programs delivered by teachers were effective. Therefore, future studies should evaluate the implementation success of programs to improve the rate of effective delivery by school staff. Overall, the field will benefit from more randomised controlled trials with comparisons to active control groups, larger sample sizes and longer-term follow-ups.
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Affiliation(s)
- Tess Jagiello
- Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney, Australia
| | - Jessica Belcher
- Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney, Australia
| | - Aswathi Neelakandan
- Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney, Australia
| | - Kaylee Boyd
- Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney, Australia
| | - Viviana M Wuthrich
- Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney, Australia.
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van Loon AWG, Creemers HE, Vogelaar S, Miers AC, Saab N, Westenberg PM, Asscher JJ. The Effectiveness of School-Based Skills-Training Programs Reducing Performance or Social Anxiety: Two Randomized Controlled Trials. CHILD & YOUTH CARE FORUM 2023; 52:1-25. [PMID: 36777191 PMCID: PMC9899115 DOI: 10.1007/s10566-023-09736-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2023] [Indexed: 02/05/2023]
Abstract
Background Given that high levels of stress during adolescence are associated with negative consequences, it is important that adolescents with psychological needs are supported at an early stage, for instance with interventions at school. However, knowledge about the potential of school-based programs targeting adolescents with psychological needs, aimed at reducing school or social stress, is lacking. Objective The current study aimed to investigate the effectiveness of two targeted school-based skills-training programs, addressing either skills to deal with performance anxiety or social skills. Methods Two randomized controlled trials were performed with participants who self-selected to one of the programs. The sample comprised of N = 361 adolescents (M age = 13.99 years, SD = 0.83) from various educational levels and ethnic identity backgrounds. The performance anxiety program included N = 196 participants (N = 95 in the experimental group), while the social skills program included N = 165 participants (N = 86 in the experimental group). MANCOVA's were performed. Results The performance anxiety program had a small effect on reducing adolescents' test anxiety. Furthermore, for adolescents who attended more than half of the sessions, the program had small effects on reducing test anxiety and fear of failure. The program did not improve adolescents' coping skills or mental health. The social skills program was not effective in improving social skills, social anxiety, and mental health. Conclusions A relatively short, targeted program addressing skills to deal with performance anxiety can have the potential to reduce adolescents' performance anxiety. Trial registration International Clinical Trials Registry Platform (Netherlands Trial Register, number NTR7680). Registered 12 December 2018. Study protocol van Loon et al., (2019). Supplementary Information The online version contains supplementary material available at 10.1007/s10566-023-09736-x.
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Affiliation(s)
- Amanda W. G. van Loon
- Child and Adolescent Studies, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands
| | - Hanneke E. Creemers
- Forensic Child and Youth Care Sciences, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, The Netherlands
| | - Simone Vogelaar
- Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
| | - Anne C. Miers
- Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
| | - Nadira Saab
- Graduate School of Teaching (ICLON), Leiden University, Kolffpad 1, 2333 BN Leiden, The Netherlands
| | - P. Michiel Westenberg
- Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
| | - Jessica J. Asscher
- Child and Adolescent Studies, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands
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Putwain DW, Beaumont J, Gallard D. Adaptability vs. buoyancy: Which offers the greater protection against test anxiety and could relations be reciprocal? LEARNING AND INDIVIDUAL DIFFERENCES 2023. [DOI: 10.1016/j.lindif.2022.102247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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5
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Pina AA, Stoll RD, Holly LE, Wynne H, Chiapa A, Parker J, Caterino L, Tracy SJ, Gonzales NA, Valdivieso A. Streamlined pediatric anxiety program for school mental health services. J Anxiety Disord 2023; 93:102655. [PMID: 36517320 PMCID: PMC9844125 DOI: 10.1016/j.janxdis.2022.102655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/08/2022] [Accepted: 11/22/2022] [Indexed: 12/10/2022]
Abstract
There needs to be serious transformation of evidence-based interventions (EBIs) into real-world solutions; otherwise, EBIs will never achieve the intended public health impact. In a randomized trial, we reported effects of a redesigned anxiety program. Herein, we described the redesign process that led to the program. Survey data revealed provider preferences for school mental health anxiety services. Focus groups and prototype feedback sessions revealed service barriers to uptake, implementation, and sustainability along with corresponding enabling strategies. Prototype feedback sessions also focused on refinement and fine-tuning of the redesign. In the end, traditional EBI strategies were transformed and packaged into six lessons, lasting 20-30 minutes each, and amenable to delivery in small-group format. The redesign achieved the intended purpose of retaining elements from cognitive and behavior therapy and social skills training for the target population of the intervention (e.g., 3rd to 5th graders with heterogeneous anxiety problems - identified and referred). The streamlined EBI is accessible from PBS LearningMedia™ - a service that hosts public, research-based, and school-ready materials.
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Affiliation(s)
- Armando A Pina
- Department of Psychology, Arizona State University, Tempe, AZ, USA.
| | - Ryan D Stoll
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Lindsay E Holly
- Department of Psychology, Marquette University, Milwaukee, WI, USA
| | - Henry Wynne
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Amanda Chiapa
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Julia Parker
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Linda Caterino
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Sarah J Tracy
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Nancy A Gonzales
- Department of Psychology, Arizona State University, Tempe, AZ, USA
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McCurdy BH, Scozzafava MD, Bradley T, Matlow R, Weems CF, Carrion VG. Impact of anxiety and depression on academic achievement among underserved school children: evidence of suppressor effects. CURRENT PSYCHOLOGY 2022; 42:1-9. [PMID: 36213567 PMCID: PMC9524334 DOI: 10.1007/s12144-022-03801-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2022] [Indexed: 11/28/2022]
Abstract
Anxiety and depression symptoms may leave children at risk for lower academic scores, though this unique linkage to academic achievement in underserved youth is less well established. This study aimed to examine how anxiety and depression are uniquely related to spelling and math achievement beyond attention and hyperactivity deficits in children in underserved schools. Children aged 8 to 11 (n = 1085, 47.3% female) from historically underserved groups (Hispanic 75.3%, American Indian 6.4%, Black 4.9%, and White 1.5%) from 13 schools across two public school districts in California participated in the assessment of emotional and behavioral health symptoms that included a spelling and math assessment. While there was no relationship between anxiety or hyperactivity on spelling and math scores, depression and attention problems were significantly negatively related to spelling and math scores. However, when entered simultaneously, evidence of suppressor effects emerged. Anxiety and hyperactivity both became positively predictive of math. Similarly, anxiety became positively predictive of spelling. Subsample analyses showed that these suppressor effects were only in females. The associations among anxiety, depression, attention, and hyperactivity with spelling and math achievement are complex, and when controlling for depression and attention, anxiety levels and hyperactivity may be motivating some level of achievement in these areas.
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Affiliation(s)
- Bethany H. McCurdy
- Human Development and Family Studies, Iowa State University, Ames, IA USA
| | | | - Travis Bradley
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA USA
| | - Ryan Matlow
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA USA
| | - Carl F. Weems
- Human Development and Family Studies, Iowa State University, Ames, IA USA
| | - Victor G. Carrion
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA USA
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7
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Radtke SR, Ollendick TH, Weems CF. Changes in Anxiety Control Beliefs Following a Brief CBT Treatment and Their Association With Anxiety Symptom Reduction. Behav Ther 2021; 52:1408-1417. [PMID: 34656195 PMCID: PMC8531535 DOI: 10.1016/j.beth.2021.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/31/2021] [Accepted: 03/19/2021] [Indexed: 11/26/2022]
Abstract
Anxiety control beliefs (i.e., beliefs regarding one's ability to cope with external, fear-inducing threats and internal reactions to those perceived threats) have been found to negatively predict anxiety symptoms in children and adults and to be modifiable by cognitive-behavioral therapy for anxiety disorders. The current study examines whether changes in anxiety control beliefs were seen following a brief, intensive treatment for specific phobias, and whether those changes were associated with improvements in the targeted phobia and comorbid anxiety disorder symptoms. Participants were 135 children and adolescents (M age = 9.01 years, 49% male) who received one-session treatment (OST) with or without parental involvement for their primary specific phobia. Results indicated that self-reported anxiety control beliefs significantly increased following treatment and that these increases significantly predicted reductions in specific phobia severity and symptoms of comorbid anxiety disorders 6 months and 1 year following treatment. Findings illustrate that involvement in a single 3-hour OST was associated with changes in anxiety control beliefs and demonstrate the potential importance of targeting control beliefs in pediatric anxiety treatment.
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Affiliation(s)
- Sarah R. Radtke
- Department of Psychology, Virginia Tech, 460 Turner Street, Suite 207, Blacksburg, VA 24060
| | - Thomas H. Ollendick
- Department of Psychology, Virginia Tech, 460 Turner Street, Suite 207, Blacksburg, VA 24060
| | - Carl F. Weems
- Human Development and Family Studies, Iowa State University, Ames, IA 50011
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Jagiello T, Wuthrich VM, Ellis LA. Implementation trial of a cognitive behavioural therapy programme for reducing student stress in the final year of secondary school. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2021; 92:e12460. [PMID: 34569055 DOI: 10.1111/bjep.12460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/03/2021] [Indexed: 11/30/2022]
Abstract
The final year of secondary school has been shown to be associated with heightened student stress. Psychological interventions have been shown to be effective in reducing and preventing distress in students during this school period, although the widespread adoption of these interventions into school settings is limited. There have been recent calls for research to examine the implementation success of evidence-based programmes when used by schools in school settings. The present study aimed to evaluate the implementation success of an evidence-based cognitive-behavioural therapy programme (Study without Stress) using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. At one Australian high school, all tutor group teachers were trained by the school counsellor to deliver the programme in standard school classes to students in the lead up to their final year of secondary school. Students (n = 80) and teachers (n = 11) reported on programme success against the RE-AIM framework at pre-intervention, post-intervention, and three-month follow-up. The findings indicated that SWOS was implemented successfully by the school. SWOS was associated with maintaining student stress levels at normal levels over time, as well as reducing the severity of stress for initially highly distressed students. The findings provide evidence from implementation science that SWOS can be adapted and delivered effectively by school staff to manage stress in final year secondary school students.
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Affiliation(s)
- Tess Jagiello
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Viviana M Wuthrich
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Louise A Ellis
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Weems CF, Russell JD, Herringa RJ, Carrion VG. Translating the neuroscience of adverse childhood experiences to inform policy and foster population-level resilience. ACTA ACUST UNITED AC 2021; 76:188-202. [PMID: 33734788 DOI: 10.1037/amp0000780] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Imaging methods have elucidated several neurobiological correlates of traumatic and adverse experiences in childhood. This knowledge base may foster the development of programs and policies that aim to build resilience and adaptation in children and youth facing adversity. Translation of this research requires both effective and accurate communication of the science. This review begins with a discussion of integrating the language used to describe and identify childhood adversity and their outcomes to clarify the translation of neurodevelopmental findings. An integrative term, Traumatic and Adverse Childhood Experiences (TRACEs+) is proposed, alongside a revised adverse childhood experiences (ACEs) pyramid that emphasizes that a diversity of adverse experiences may lead to a common outcome and that a diversity of outcomes may result from a common adverse experience. This term facilitates linkages between the ACEs literature and the emerging neurodevelopmental knowledge surrounding the effect of traumatic adverse childhood experiences on youth in terms of the knowns and unknowns about neural connectivity in youth samples. How neuroscience findings may lead directly or indirectly to specific techniques or targets for intervention and the reciprocal nature of these relationships is addressed. Potential implications of the neuroscience for policy and intervention at multiple levels are illustrated using existing policy programs that may be informed by (and inform) neuroscience. The need for transdisciplinary models to continue to move the science to action closes the article. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Carl F Weems
- Department of Human Development and Family Studies, Iowa State University
| | - Justin D Russell
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Ryan J Herringa
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison
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Pina AA, Gonzales NA, Mazza GL, Gunn HJ, Holly LE, Stoll RD, Parker J, Chiapa A, Wynne H, Tein JY. Streamlined Prevention and Early Intervention for Pediatric Anxiety Disorders: A Randomized Controlled Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 21:487-497. [PMID: 31927654 PMCID: PMC7166170 DOI: 10.1007/s11121-019-01066-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
There is a need to optimize the fit between psychosocial interventions with known efficacy and the demands of real-word service delivery settings. However, adaptation of evidence-based interventions (EBI) raises questions about whether effectiveness can be retained. This randomized controlled trial (RCT) evaluated a streamlined package of cognitive, behavior, and social skills training strategies known to prevent and reduce anxiety symptom and disorder escalation in youth. A total of 109 youth (Mage = 9.72; 68% girls; 54% Latinx) at risk based on high anxiety were randomized to the streamlined prevention and early intervention (SPEI) (n = 59) or control (n = 50) and were assessed at pretest, posttest, and 12-month follow-up. A main objective was to determine whether our redesign could be delivered by community providers, with acceptable levels of fidelity, quality, and impact. In terms of process evaluation results, there was high protocol fidelity, excellent clinical process skills, few protocol adaptations, and high satisfaction with the SPEI. In terms of outcomes, there were no significant main or moderated effects of the SPEI at the immediate posttest. However, at the follow-up, youth in the SPEI reported greater self-efficacy for managing anxiety-provoking situations, greater social skills, and fewer negative cognitive errors relative to controls. Collectively, findings suggest that the redesigned SPEI might be an attractive and efficient solution for service delivery settings.
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Affiliation(s)
- Armando A Pina
- Department of Psychology, Arizona State University, Tempe, AZ, 871104, USA.
| | - Nancy A Gonzales
- Department of Psychology, Arizona State University, Tempe, AZ, 871104, USA
| | - Gina L Mazza
- Department of Psychology, Arizona State University, Tempe, AZ, 871104, USA
| | - Heather J Gunn
- Department of Psychology, Arizona State University, Tempe, AZ, 871104, USA
| | - Lindsay E Holly
- Department of Psychology, Marquette University, Milwaukee, WI, 53233, USA
| | - Ryan D Stoll
- Department of Psychology, Arizona State University, Tempe, AZ, 871104, USA
| | - Julia Parker
- Department of Psychology, Arizona State University, Tempe, AZ, 871104, USA
| | - Amanda Chiapa
- Department of Psychology, Arizona State University, Tempe, AZ, 871104, USA
| | - Henry Wynne
- Department of Psychology, Arizona State University, Tempe, AZ, 871104, USA
| | - Jenn-Yun Tein
- Department of Psychology, Arizona State University, Tempe, AZ, 871104, USA
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11
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Weems CF. Commentary on the Special Issue on Network Analysis: Assessment, Intervention, Theory, and the Nature of Reality: Actualizing the Potential of Network Perspectives on Posttraumatic Stress Disorder. J Trauma Stress 2020; 33:116-125. [PMID: 32061111 DOI: 10.1002/jts.22482] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 12/03/2019] [Indexed: 12/12/2022]
Abstract
This commentary on the Journal of Traumatic Stress special issue on network analysis explores the network perspective on posttraumatic stress disorder (PTSD), emphasizing the advances in research made in this collection of articles. The commentary is organized around the following themes related to actualizing the perspective's methodological, assessment, and intervention potential and the potential shift in the theoretical underpinnings of mental disorders that networks models imply. First, extant data using network analysis suggest that reactions to traumatic stress are more complicated than once thought but that this complexity does not mean efficient, relatively simple heuristics to aid assessment and intervention do not exist. Attention to methodological issues in symptom assessment may help move this aspect of the research forward. Second, the extant research is largely correlational and has not yet established causal linkages, although temporal associations underlying network models are being identified. Prospective and intervention studies employing network analysis are critical. Third, the network perspective of PTSD symptoms may advance research on the mechanisms of risk and resilience (e.g., neurodevelopmental, cognitive behavioral, emotional, and social models) by helping link symptoms to theoretical causal processes. A developmental framework that views the effect of traumatic stress in terms of temporal cascades of reactions with both negative and potentially positive cognitive, behavioral, social, and emotional outcomes fits the network analysis model. Fourth, network models call into question some of the fundamental assumptions underlying the conceptualization of mental disorders, leaving several ontological questions and implications currently unanswered; research examining the implications of the new assumptions is needed.
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Affiliation(s)
- Carl F Weems
- Department of Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
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12
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van Loon AWG, Creemers HE, Vogelaar S, Saab N, Miers AC, Westenberg PM, Asscher JJ. The effectiveness of school-based skills-training programs promoting mental health in adolescents: a study protocol for a randomized controlled study. BMC Public Health 2019; 19:712. [PMID: 31174502 PMCID: PMC6556042 DOI: 10.1186/s12889-019-6999-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/16/2019] [Indexed: 02/08/2023] Open
Abstract
Background Adolescence is a period of elevated stress sensitivity, which places adolescents at increased risk of developing mental health problems such as burnout, depression, anxiety, and externalizing problems. Early intervention of psychological needs and low-threshold care addressing such needs may prevent this dysfunctional development. Schools may provide an important environment to identify and address psychological needs. The aim of this protocol is to describe the design of a study aiming to evaluate the effectiveness of low-threshold school-based skills-training programs promoting the mental health of adolescents and to examine moderators of the effectiveness. Methods A Randomized Controlled Trial will be conducted to examine the effectiveness of two school-based skills-training programs aiming to promote mental health by improving either skills to deal with performance anxiety or social skills. A multi-informant (i.e., students, parents, and trainers) and multi-method (i.e., questionnaires and physiological measurements) approach will be used to assess program targets (skills to deal with performance anxiety or social skills), direct program outcomes (performance or social anxiety) and mental health outcomes (i.e., stress, internalizing and externalizing problems, self-esteem and well-being), as well as specific moderators (i.e., student, parent and program characteristics, social support, perfectionism, stressful life events, perceived parental pressure, positive parenting behavior, treatment alliance and program integrity). Discussion The current study will provide information on the effectiveness of school-based skills-training programs. It is of crucial importance that the school environment can provide students with effective, low-threshold intervention programs to promote adolescents’ daily functioning and well-being and prevent the emergence of mental health problems that negatively affect school performance. Trial registration Dutch Trial Register number NL7438. Registered 12 December 2018.
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Affiliation(s)
- Amanda W G van Loon
- Child and Adolescent Studies, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, the Netherlands.
| | - Hanneke E Creemers
- Forensic Child and Youth Care Sciences, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, the Netherlands
| | - Simone Vogelaar
- Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands
| | - Nadira Saab
- Graduate School of Teaching (ICLON), Leiden University, Kolffpad 1, 2333 BN, Leiden, the Netherlands
| | - Anne C Miers
- Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands
| | - P Michiel Westenberg
- Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands
| | - Jessica J Asscher
- Child and Adolescent Studies, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, the Netherlands.,Forensic Child and Youth Care Sciences, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, the Netherlands
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13
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Gronholm PC, Nye E, Michelson D. Stigma related to targeted school-based mental health interventions: A systematic review of qualitative evidence. J Affect Disord 2018; 240:17-26. [PMID: 30041074 DOI: 10.1016/j.jad.2018.07.023] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/22/2018] [Accepted: 07/08/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND School-based mental health services have been advocated to increase access to psychological support for children and adolescents. However, concerns have been raised about the potential stigma associated with selection of students and the visibility of school-based service contact. METHODS This review assessed findings from qualitative studies to identify potential stigmatising effects of participation in targeted school-based mental health interventions for students attending primary- or secondary-level education. Eight articles (reflecting seven studies) were identified through electronic database searches (PsycInfo, EMBASE, Medline, CINAHL, ERIC), supplemented by citation and reference searches and expert consultations. Data were synthesised according to established guidelines for thematic synthesis. RESULTS Three overarching themes were identified: "anticipated and experienced stigma", "consequences of stigma" and "mitigating strategies". These findings illustrate how pervasively stigma can compromise efforts to increase access to mental health care through targeted school-based provision, while also outlining strategies endorsed by students for alleviating the risk and/or impact of stigma. LIMITATIONS The findings need to be considered in view of the relative scarcity of surveyed evidence. Furthermore, as all evidence came from high-income and Western countries, the applicability to other contexts is unclear. CONCLUSIONS This synthesis reflects the first overview of qualitative evidence regarding stigmatising experiences and concerns associated with students' engagement with targeted school-based mental health interventions. The findings should inform efforts for mitigating stigma-related barriers to students' engagement in targeted mental health support, and serve to guide future research in this area.
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Affiliation(s)
- Petra C Gronholm
- Personal Social Services Research Unit, London School of Economics and Political Science, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - Elizabeth Nye
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, UK
| | - Daniel Michelson
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene & Tropical Medicine, UK
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Russell JD, Neill EL, Carrión VG, Weems CF. The Network Structure of Posttraumatic Stress Symptoms in Children and Adolescents Exposed to Disasters. J Am Acad Child Adolesc Psychiatry 2017; 56:669-677.e5. [PMID: 28735696 DOI: 10.1016/j.jaac.2017.05.021] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 05/24/2017] [Accepted: 06/01/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To evaluate current theoretical assumptions about the nature of pediatric posttraumatic stress disorder (PTSD) by examining the network structure of PTSD in a sample of youth exposed to disasters and testing for age differences. Network analysis provides the opportunity to identify "central" symptoms that might hold an outsized influence over others and are important targets for research and treatment. The authors hypothesized that particular symptoms would exhibit greater influence over others. They further hypothesized marked differences in symptom networks across children and adolescents. METHOD Participants were 786 youth 8 to 13 years old (children) and 14 to 18 years old (adolescents) exposed to Hurricanes Katrina and Gustav who were assessed for PTSD symptoms using the University of California-Los Angeles PTSD Reaction Index for Children. Network models were computed and constructed using the R-package qgraph, which estimates associations between symptoms and forms graphic network models. RESULTS Consistent with the hypotheses, the symptom network demonstrated meaningful variability across age, particularly in the strength of associations, and the relative importance of individual symptoms to the network as a whole. Results further demonstrated that symptoms cluster together in a manner that adds a unique perspective to current model conceptualizations. CONCLUSION Network analysis is a potentially important additional conceptualization of psychopathology with related data analytic techniques. Results suggest that PTSD can be characterized as a web of interactions between symptoms. This work illuminates differences in the PTSD symptom network across development, such as the link between numbness of negative affect and amnesia in children, but not in teens, and how the critical symptoms within that network differ across childhood and adolescence. Network analysis could allow the re-envisioning of the nature of this complex disorder with new avenues for research and clinical practice.
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La Greca AM, Ehrenreich-May J, Mufson L, Chan S. Preventing Adolescent Social Anxiety and Depression and Reducing Peer Victimization: Intervention Development and Open Trial. CHILD & YOUTH CARE FORUM 2016; 45:905-926. [PMID: 27857509 PMCID: PMC5108624 DOI: 10.1007/s10566-016-9363-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Social anxiety disorder (SAD) and depression are common among adolescents, frequently comorbid, and resistant to change. Prevention programs for adolescent SAD are scant, and depression prevention programs do not fully address peer-risk factors. One critical peer-risk factor for SAD and depression is peer victimization. We describe the development and initial evaluation of a transdiagnostic school-based preventive intervention for adolescents with elevated symptoms of social anxiety and/or depression and elevated peer victimization. We modified Interpersonal Psychotherapy-Adolescent Skills Training for depression, incorporating strategies for dealing with social anxiety and peer victimization. OBJECTIVE Our open trial assessed the feasibility, acceptability, and preliminary benefit of the modified program (called UTalk) for adolescents at risk for SAD or depression and who also reported peer victimization. METHOD Adolescents (N=14; 13-18 years; 79% girls; 86% Hispanic) were recruited and completed measures of peer victimization, social anxiety, and depression both pre- and post-intervention and provided ratings of treatment satisfaction. Independent evaluators (IEs) rated youths' clinical severity. The intervention (3 individual and 10 group sessions) was conducted weekly during school. RESULTS Regarding feasibility, 86% of the adolescents completed the intervention (M attendance=11.58 sessions). Satisfaction ratings were uniformly positive. Intention-to-treat analyses revealed significant declines in adolescent- and IE-rated social anxiety and depression and in reports of peer victimization. Additional secondary benefits were observed. CONCLUSIONS Although further evaluation is needed, the UTalk intervention appears feasible to administer in schools, with high satisfaction and preliminary benefit. Implications for research on the prevention of adolescent SAD and depression are discussed.
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A Control-Value Theory Approach: Relationships Between Academic Self-Concept, Interest, and Test Anxiety in Elementary School Children. CHILD & YOUTH CARE FORUM 2016. [DOI: 10.1007/s10566-016-9362-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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School Dissatisfaction in a Post-disaster Environment: The Mediating Role of Posttraumatic Stress Symptoms. CHILD & YOUTH CARE FORUM 2015. [DOI: 10.1007/s10566-015-9316-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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